With technological advances in modern medicine, the digital transformation of diagnostic data for medical interpretation and analysis has heightened the focus on clinical quality, standardization and efficiency. In the 1990s, the Digital Imaging and Communications in Medicine (DICOM) standards were published by the American College of Radiology and the National Electronic Manufacturers Association in order to outline the data format, flow, and hierarchy of electronic information of diagnostic images and related information between computer systems over TCP/IP networks. With the advances in digital imaging and the transfer of this information over TCP/IP networks, medical professions, such as cardiology, have begun to adopt standardized clinical reports that outline the basic content for medical interpretation and analysis. Organizations like the American Society of Echocardiography (ASE) and the DICOM Standards Committee have developed a uniform structure and set of codes for the transfer of echocardiography reporting information (DICOM Supplement 72, Echocardiography Procedure Reports, Jun. 23, 2003). The outcome of these organization's advancements pertaining to standardizing the transfer of clinical information is the result of historical frustration to effectively share data between proprietary information systems and DICOM imaging modalities (for example, ultrasound machines, X-ray machines, CT scan devices, nuclear imaging devices, etc.), such as not being able to communicate and transfer common measurements and information for clinical use. In many fields including medicine, veterinary medicine, and scientific manufacturing and investigation, it is necessary to render a report based on professional subjective interpretation. Due to the amount of variance resulting in personal opinion, these reports may differ greatly within the same profession. As a consequence to the variability in interpretation, organizations are establishing standardized approaches for the creation of interpretive reports. In medicine, these reports prove vital in the legal, professional diagnostic analysis, and medical interpretation of the patient's condition, and can further provide a basis for future assessments and ongoing treatments. Whether in the hospital setting, clinical setting, physician practice, or health service setting, clinical reporting provides a legal, confidential record of a clinician's assessment of a patient's condition.
Typically, a clinical report consists of basic clinical information related to the patient's exam including but not limited to patient demographic information, date & time of the study, performing examiner's name, interpreting physician name(s), reimbursement code(s), study quality, clinical assessment, medical findings, diagnostic measurements, diagnostic data, vital information, diagrams, and impressions. Contemporary methods for creating clinical reports includes performing a diagnostic exam on a patient, whereby a physician reviews the diagnostic information, such as digital ultrasound, and either manually documents the clinical findings and diagnostic impression, or the physician dictates this basic clinical information into a recording device, such as a Dictaphone, where it is later transcribed into a document format that becomes part of the patient's permanent chart. These methods either delay the report processing time or limit the physician to using only designated workstations solely for this purpose. These reporting methods often result in furthering the variability in producing accurate reports, limit the workflow, are inefficient, or are not cost effective. To confound the variability in clinical reporting, DICOM modalities often utilized proprietary coding schemas for labeling the clinical information, which results in complicating, if not comprising, the integration of this data with additional information systems used by medical professionals.
It is also important that clinical information be held confidential and secure from unauthorized use. The Health Insurance Portability and Accountability Act (HIPAA) authorized medical professionals to protect the confidentiality of patients' medical records, such as clinical reports. The impact of HIPAA instituted a duty on medical professionals to comply with these governmental standards of conduct by requiring the secure transfer of patient data/information using secure TCP/IP network encryption technology, like Secure Socket Layer (SSL) encryption or Virtual Private Network (VPN) techniques over public communication networks. Public networks provide a cost-effective communication option to accessing information and data over the Internet, or world-wide-web. Using TCP/IP communication protocol and encryption, like SSL or VPN, medical professionals can access clinical information, such as DICOM data, images, media, etc. over the Internet. However, while the Internet provides medical professionals access to this information over the public communications network, traditional imaging modalities along with their software architectures do not enable medical professionals to remotely render a clinical structured report, particularly in a DICOM Structured Report format.
As a result, physicians have turned to utilizing technological innovations that depict digital diagnostic images in place of analog systems or static radiological imagery. While these formats for medical interpretation are growing in medical application, these systems and methods rely on utilizing local area networks for communicating, transmitting, and processing the digital data and medical media between computers. With the expansion of health systems and the growth in competition between physicians and hospitals over reimbursement, physicians have begun to incorporate Picture Archiving and Communications System (PACS) into their workplace for the storage and retrieval of medical images and video. While these systems are expanding in the marketplace, most clinical reporting technologies are limited to local area networks and do not enable the remote rendering of clinical structured reports over the Internet.
Many inventors have attempted to solve these problems by allowing the medical professionals to only view a completed clinical report over the Internet using a VPN or SSL connection; these methods do not permit the user to create and render a DICOM Structured Report format of a clinical report over the Internet. One such method is to provide the local viewing of diagnostic digital images and video clips and report rendered over a local area network whereby the user operates a viewer, such as a DICOM viewer, and a reporting software system; however in this method, the user generates and renders a report that is limited to only the LAN network architecture and not the Internet.
Moreover, traditional DICOM imaging modalities store DICOM data in proprietary formats which often require optical character recognition (OCR) for capturing and populating measurements into reports. These software applications perform “screen scrubbing” of the DICOM image bitmap that contains the measurements from the static image or image worksheet and populate the data into a database system, such as Microsoft Excel and Microsoft Access. On the other hand, new contemporary DICOM modalities, such as the Philips HD11 ultrasound system, Philips IE33, and the GE Vivid 7, now transmit the DICOM data in a DICOM Structured Report (DSR) format based on the DICOM Supplement 72 structure and format for transmitting ultrasound data and information (example, measurements). However, these technologies employ DICOM SR standard for procedure reports only, and do not take an advantage of DSR for creating diagnostic reports. They do not enable a user to render DSR clinical reports, build new DSR report templates (example, transthoracic echocardiography report, obstetrical report, etc.), store data obtained from OCR data into the DSR format, or alter (customize) the graphical user interface (GUI) for creating and amending DICOM structured reports. Additionally, contemporary inventions do not combine web-viewing of DICOM data and DICOM Structured Reports where the DICOM viewer uses the “Web Access to Data Objects” (WADO) protocol, which is the DICOM standard way to access images through an Internet browser via HyperText Transfer Protocol (HTTP), the underlying protocol used by the World Wide Web (HTTP defines how messages are formatted and transmitted, and what actions Web severs and browsers should take in response to various commands).
In lieu of the technological shortcomings of these various currently 170 available systems, there is still a need for an Internet-based software for rendering structured reports, particularly DSR, in an efficient, timely manner with an easy-to-use graphical user interface. Specifically, there is a desire for a system and method for creating and rendering clinical structured reports over the Internet using an encrypted, SSL connection in accordance with DICOM standards.
It is, therefore, a feature of the present invention to provide a system and method of creating and rendering structured clinical reports over the Internet.
Additional features and advantages of the invention will be set forth in part in the description which follows, and in part will become apparent from the description, or may be learned by practice of the invention. The features and advantages of the invention may be realized by means of the combinations and steps particularly pointed out in the appended claims.